Basic Information
| Provider Information | |||||||||
| NPI: | 1043331481 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HSIAO | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2420 CAMINO RAMON | ||||||||
| Address2: | STE. 270 | ||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945834385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9255430140 | ||||||||
| FaxNumber: | 9255430145 | ||||||||
| Practice Location | |||||||||
| Address1: | 2420 CAMINO RAMON | ||||||||
| Address2: | STE. 270 | ||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945834385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9255430140 | ||||||||
| FaxNumber: | 9255430145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 12/18/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A101293 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.